Yeon-Joo Kim; Young-Il Kim; Young-A Song; Nam-Cheol Jin; Sung-Ryoun Lim; Dae-Yeul Ryang; Kyoung-Myeun Chung; Seon-Young Park; Chang-Hwan Park; Hyun-Soo Kim; Sung-Kyu Choi; Jong-Sun Rew

doi:10.4068/cmj.2008.44.2.72

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Kim, Kim, Song, Jin, Lim, Ryang, Chung, Park, Park, Kim, Choi, and Rew: The Effectiveness of Combination Therapy with Peginterferon α-2a and Ribavirin in Chronic Hepatitis C

Original Article

Chonnam Medical Journal

Chonnam Medical Journal 2008; 44(2): 72-81.

Published online: 31 August 2008

DOI: https://doi.org/10.4068/cmj.2008.44.2.72

The Effectiveness of Combination Therapy with Peginterferon α-2a and Ribavirin in Chronic Hepatitis C

Yeon-Joo Kim, Young-Il Kim, Young-A Song, Nam-Cheol Jin, Sung-Ryoun Lim, Dae-Yeul Ryang, Kyoung-Myeun Chung, Seon-Young Park, Chang-Hwan Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew

Department of Internal Medicine, Chonnam National University Medical School, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea.

Corresponding author (choisk@chonnam.ac.kr)

Accepted 6 July 2008

Abstract

The purpose of this study was to evaluate the efficacy and safety of peginterferon alfa-2a plus ribavirin therapy in patients with chronic hepatitis C in Gwangju-Jeonnam area. Eighty-four patients with detectable HCV RNA were eligible for the study. Genotype-non-1 patients were treated with peginterferon alfa-2a 180 mcg/week plus ribavirin 800 mg/day for 24 weeks and genotype-1 patients were treated with peginterferon alfa-2a 180 mcg/week plus ribavirin 1,000-1,200 mg/day for 48 weeks. The end of treatment virologic response (ETVR), the sustained virologic response (SVR), the end of treatment of biochemical response (ETBR), the sustained biochemical response (SBR) and the adverse events were analyzed. The overall ETVR was 95.8%; 64.1% in genotype-1 group and 96.4% in genotype-non-1 group (p=0.56). The overall SVR was 80.4%; 60.0% in genotype-1 group and 86.1% in non-1 group (p=0.087). The ETBR was 72.2% and the SBR was 95.7%. In genotype-non-1, body mass index had independent effect on the SVR (p=0.038). Eight patients (32.0%) in the genotype-1 group and 4 patients (6.8%) in the non-1 group dropped out at the end of treatment, and 7 (8.3%) of 84 patients discontinued due to adverse events. This study shows that combination therapy with peginterferon and ribavirin as an initial treatment for chronic hepatitis C patients in this area is safe and effective as compared with Western and other reports; and that the body mass index may be regarded as one of the significant factors influencing the SVR.

Keywords: Chronic hepatitis C, Peginterferon alfa-2a, Ribavirin, Sustained virologic response, Adverse events

Figures and Tables

Fig. 1

Hepatitis C genotypes of patients.

Fig. 2

Patient flow diagram. EVR, early virologic response; ETVR, end of treatment virologic response; SVR, sustained virologic response; n, number.

Fig. 3

End of treatment virologic response (ETVR) and sustained virologic response (SVR) and end of treatment biochemical response (ETBR) and sustained biocemical response (SBR) according to the genotype of hepatitis C virus. ETVR and SVR was 95.8% and 80.4% and ETBR and SBR was 72.2% and 95.7%. There was not significantly different between patients with genotype 1 and those with genotype non-1 (ETVR, 94.1% vs. 96.4% p=0.56; SVR, 60.0% vs. 86.1% p=0.087; ETBR, 58.8% vs. 76.4%; p=0.112; SBR, 90.0% vs. 97.2% p=0.37).

Table 1

Baseline characteristics of patients according to hepatitis C virus genotype

SD, standard deviation; n, number; ^*, Paired sample t-test; ^†, Pearson chi-square test; ^‡, Fisher's exact test; AST, aspartate aminotransferase; ALT, aspartate aminotransferase; ALP, alkaline phosphatase

Table 2

Factors influencing on sustained virologic response in chronic hepatitis C caused by HCV genotype 1

BMI, body mass index; n, number; ^*, Paired sample t-test; ^†, Fisher's exact test

Table 3

Factors influencing on sustained virologic response in chronic hepatitis C caused by HCV genotype non-1

BMI, body mass index; n, number; ^*, Paired sample t-test; ^†, Fisher's exact test

Table 4

Adverse effects of combination therapy with peginterferon and ribavirin

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